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Imaging of the Fibrous Cap in Atherosclerotic Carotid Plaque

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Abstract

In the last two decades, a substantial number of articles have been published to provide diagnostic solutions for patients with carotid atherosclerotic disease. These articles have resulted in a shift of opinion regarding the identification of stroke risk in patients with carotid atherosclerotic disease. In the recent past, the degree of carotid artery stenosis was the sole determinant for performing carotid intervention (carotid endarterectomy or carotid stenting) in these patients. We now know that the degree of stenosis is only one marker for future cerebrovascular events. If one wants to determine the risk of these events more accurately, other parameters must be taken into account; among these parameters are plaque composition, presence and state of the fibrous cap (FC), intraplaque haemorrhage, plaque ulceration, and plaque location. In particular, the FC is an important structure for the stability of the plaque, and its rupture is highly associated with a recent history of transient ischaemic attack or stroke. The subject of this review is imaging of the FC.

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Acknowledgments

The authors are grateful to Aldo Saitz, Ermanno Saitz, Clemente Atzeni, Paolo Contu, Franco Conti, and Diana Caravana for their valuable help regarding MDCTA and MRI. Moreover, we are deeply indebted to Tiziana Langella, Roberto Sanfilippo, Roberto Montisci, and Letizia Lai.

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Authors and Affiliations

  1. Department of Radiology, Azienda Ospedaliero-Universitaria di Cagliari, Polo di Monserrato, s.s. 554 Monserrato, Cagliari, 09045, Italy

    Luca Saba & Giorgio Mallarini

  2. Department of Radiology, Erasmus Medical Center Rotterdam, S-Gravendijkwal 230, Rotterdam, 3015 CE, The Netherlands

    Fons Potters & Aad van der Lugt

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  1. Luca Saba
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  2. Fons Potters
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  4. Giorgio Mallarini
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Correspondence to Luca Saba.

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Saba, L., Potters, F., van der Lugt, A. et al. Imaging of the Fibrous Cap in Atherosclerotic Carotid Plaque. Cardiovasc Intervent Radiol 33, 681–689 (2010). https://doi.org/10.1007/s00270-010-9828-8

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  • DOI: https://doi.org/10.1007/s00270-010-9828-8

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